Test – State Housing Company Ltd.

Name *

First

Last

Local Address *

Address Line 1

Address Line 2

City

State / Province / Region

Overseas Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

EMAIL *

NATIONALITY *

VALID ID (if any) *

ID NUMBER *

HOUSE TYPE *

PREFERRED HOUSE / APARTMENT *

NUMBER OF ROOMS *

NEXT OF KIN (NAME, CONTACT No, ADDRESS) *

Upload ID

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Upload Passport Picture

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Signature

Message